某大型教学医院2013—2015年铜绿假单胞菌的耐药性监测

发布时间：2018-11-20 20:21

【摘要】：目的对2013—2015年我院临床标本中分离出的铜绿假单胞菌的耐药情况进行分析,以指导临床合理用药。方法对2013年1月—2015年12月我院临床送检标本进行常规分离培养,采用法国Bio Mérieux Vitek2 Compact系统和Vitek MS进行菌株鉴定,药物敏感性试验采用Vitek2 compact或者K-B法,用WHONET 5.6软件对药敏数据进行分析。结果 2013—2015年我院共分离2092株铜绿假单胞菌非重复菌株,每年均占所有分离菌株的10%左右,其中1230株来源于痰标本,占58.8%,其次为分泌物364株(17.4%)和尿224株(10.7%)。病区来源最高为呼吸病房,占17.0%,其次为重症医学科(12.3%)和神经外科(8.5%)。其中,黏液性铜绿假单胞菌的分离率每年依次为7.6%、9.4%和10.0%,呈逐年增加趋势。所有铜绿假单胞菌对常规测定药物的耐药率均低于30%,对亚胺培南的耐药率最高(25.4%),对阿米卡星的耐药率最低(9.0%),但是近3年多重耐药的铜绿假单胞菌分离率有所增加,逐年分别为10.7%、12.1%和13.1%。并且统计耐药性变迁时发现近3年美罗培南最低抑菌浓度(minimal inhibitory concentration,MIC)为16μg/m L的铜绿假单胞菌比例逐年增高(9.0%、13.2%和14.1%),环丙沙星MIC为4μg/m L的铜绿假单胞菌比例却逐年降低(20.1%、14.3%和13.6%)。结论我院铜绿假单胞菌的分离率近3年都比较稳定,但多重耐药菌分离率有增加趋势,特别是黏液型铜绿假单胞菌的分离率逐年增加更应引起临床重视。掌握我院铜绿假单胞菌的临床分布和耐药性变迁,可以为临床提供资料,更好地控制铜绿假单胞菌感染。
[Abstract]:Objective to analyze the drug resistance of Pseudomonas aeruginosa isolated from clinical samples in our hospital from 2013 to 2015. Methods the clinical samples from January 2013 to December 2015 were isolated and cultured routinely. The strains were identified by French Bio M 茅 rieux Vitek2 Compact system and Vitek MS. The drug sensitivity test was performed by Vitek2 compact or K-B method. Drug sensitivity data were analyzed by WHONET 5.6 software. Results A total of 2092 strains of Pseudomonas aeruginosa were isolated in our hospital from 2013 to 2015, accounting for about 10% of all isolates each year, of which 1230 strains were from sputum samples, accounting for 58.8%. The second was 364 strains (17.4%) of secretions and 224 strains (10.7%) of urine. Respiratory ward accounted for 17.0%, followed by ICU (12.3%) and neurosurgery (8.5%). Among them, the isolation rate of Pseudomonas aeruginosa was 7.6% and 10.0% respectively, which showed an increasing trend year by year. The drug resistance rate of all Pseudomonas aeruginosa to routine test was lower than 30%, the resistance rate to imipenem was the highest (25.4%), and to amikacin was the lowest (9.0%). However, the isolation rate of Pseudomonas aeruginosa with multiple drug resistance in recent three years increased to 10.7% and 13.1% respectively. In the last three years, the percentage of Pseudomonas aeruginosa with minimum inhibitory concentration of meropenem (minimal inhibitory concentration,MIC) of 16 渭 g / mL increased year by year (9.0% and 14.1%). The percentage of Pseudomonas aeruginosa with ciprofloxacin MIC of 4 渭 g / mL decreased year by year (20.1% and 13.6%). Conclusion the isolation rate of Pseudomonas aeruginosa in our hospital is stable in recent three years, but the isolation rate of multidrug resistant bacteria has an increasing trend, especially the increasing rate of myxotypic Pseudomonas aeruginosa should be paid more attention to. Mastering the clinical distribution and drug resistance changes of Pseudomonas aeruginosa in our hospital can provide clinical data for better control of Pseudomonas aeruginosa infection.
【作者单位】：重庆医科大学附属第一医院医学检验科;
【分类号】：R446.5

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